States have started removing people from Medicaid, which they couldn’t do for three years during the COVID-19 pandemic.
State Medicaid programs are reviewing the eligibility of about 90 million beneficiaries in the United States now that a rule suspending that process has expired. Those who remain eligible should be able to keep their coverage, and those who won’t lose it.
But new data from states that have begun this process shows that hundreds of thousands of people are losing coverage — not because of income, but because of administrative issues, like missing a renewal notification in the mail.
And one poll this week from KFF found that 65% of Medicaid enrollees nationwide were unaware that states can now remove people from the program if they are ineligible or do not complete the renewal process.
“I’ve been worrying for a year and a half,” says Joan Alcher, public policy researcher and executive director of the Georgetown Center for Children and Families. “If anything, I’m afraid it will turn out worse than I expected in some places.”
For example in Florida, nearly 250,000 people lost coverage in April, and 82% of them were for procedural reasons, Alker found after reviewing data provided by the state to federal health officials. Many of those who have lost coverage are children because Florida has not extended Medicaid to more low-income adults.
Liz Adams of Plant City, Florida has two children and they were among those in Florida who lost their coverage in April. She discovered it while trying to determine the time of her son’s biopsy appointment. Her son is a leukemia survivor and suffers from a variety of lingering health issues.
“I called the surgery center [asking] what time is this meeting? ‘Oh, we canceled that. He doesn’t have insurance,” she said. “So I jump on the gate and of course they don’t have insurance.”
She was incredibly frustrated to then have to try to re-enroll her children on health insurance, while figuring out how to get her son’s care back on track.
“I waited a year to get in with a rheumatologist, and we finally got the biopsy and we finally got the blood work, and I can’t do anything because they canceled my insurance,” she says.
With the help of Family Health Foundationshe was able to enroll her children in new health coverage and she finally had her son’s biopsy postponed to the end of June.
“I’m very worried about Florida,” Alker said. “We heard the call center was overwhelmed, the reviews are very confusing in Florida – they’re very hard to understand.”
Some other states have also removed many people from Medicaid. But Alker says the trigger isn’t bad in any state.
“We really see a divergence here,” she says. “We’ve seen very, very worrying numbers from Florida, Arkansas, Indiana, but we’ve seen much more reassuring numbers from Arizona and Pennsylvania.”
In Pennsylvania, for example, only 10% of people whose Medicaid eligibility was reviewed in April lost coverage, and in Arizona that figure was 17%, according to a status report.
The federal government can require states to suspend unenrolling people from Medicaid if something goes wrong, Alker says, but whether federal health officials will use that enforcement power remains to be seen.